Diagnose and deal with dementia
By Ryan DuBosar
Internal medicine physicians are well positioned to recognize the many forms of dementia and their stage-specific challenges, according to Zaldy Tan, MD, MPH, FACP.
“Dementia is a broad field in that there are many different types of dementia," he said. “Within each type of dementia, there are various stages. The challenges that are associated with each of these stages and each type of dementia vary.”
In a Thursday talk, Dr. Tan will offer guidance on screening for and diagnosing dementia in primary care, as well as on managing cognitive and behavioral symptoms.
Alzheimer's is the most common type of dementia, but other forms are also likely to turn up in practice, such as Lewy body dementia, frontotemporal dementia, and vascular dementia, said Dr. Tan, who is director of the Lynn Family Memory and Healthy Aging Program, medical director of the Jona Goldrich Center for Alzheimer's and Memory Disorders, and professor of medicine and neurology at Cedars Sinai Medical Center in Los Angeles.
“It is important for an internist to be able to distinguish between these types of dementia because the presentation could be different, the prognosis could be different, and the treatments could be different,” he said. “Within each stage, there are different challenges for people with mild, moderate, and late-stage for each of these types of dementia.”
Dr. Tan plans to cover the current clinical standards for diagnosis of Alzheimer's disease and other forms of dementia, as well as available treatments, including monoclonal antibodies and disease-modifying therapies recently approved by the FDA for treatment of Alzheimer's disease. “Internists will be getting a lot more questions about these medications, because they're relatively new,” he said.
Other sections of the talk will address how to manage behavioral issues in people in the late stages of dementia, as well as prevention of the disease. Physicians can encourage midlife patients interested in preventing dementia to make lifestyle changes that can potentially reduce risk, including controlling blood pressure, quitting smoking, getting enough sleep, eating a healthy diet, and avoiding excess alcohol, Dr. Tan said. ■